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The graft-versus-leukemia effect of nonmyeloablative stem cell allografts may not be sufficient to cure chronic myelogenous leukemia.
Bone Marrow Transplant. 2003 Nov; 32(9):897-901.BM

Abstract

We treated 12 patients with chronic myelogenous leukemia (CML) with a low-intensity preparative regimen followed by allogeneic stem cell transplantation in an attempt to confer a curative graft-versus-leukemia (GVL) effect with minimum morbidity. Seven patients in first chronic phase (CP1) and five in second chronic phase (CP2) (age 15-68 years) received a nonmyeloablative conditioning regimen of fludarabine and cyclophosphamide, followed by a G-CSF-mobilized peripheral blood stem cell (PBSC) transplant from an HLA-identical sibling. Cyclosporine (CsA) was used for graft-versus-host disease (GVHD) prophylaxis. Median follow-up was 384 days. Neutrophil recovery occurred at a median of 12 days. There was no transplant-related mortality. Of the seven CP1 patients transplanted, seven achieved a stable molecular remission; two with no post-transplant intervention, three after donor lymphocytes, imatinib and interferon, and two after a myeloablative stem cell transplant. Four of five CP2 patients died in blast crisis and one survived in molecular remission. Of the 12 patients with durable engraftment, six had Grades II-IV acute GVHD; six had limited chronic GVHD. These results suggest that cytoreduction is required to optimize the curative effect of allogeneic stem cell transplantation for CML.

Authors+Show Affiliations

Stem Cell Allotransplantation Section, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

14561990

Citation

Sloand, E, et al. "The Graft-versus-leukemia Effect of Nonmyeloablative Stem Cell Allografts May Not Be Sufficient to Cure Chronic Myelogenous Leukemia." Bone Marrow Transplantation, vol. 32, no. 9, 2003, pp. 897-901.
Sloand E, Childs RW, Solomon S, et al. The graft-versus-leukemia effect of nonmyeloablative stem cell allografts may not be sufficient to cure chronic myelogenous leukemia. Bone Marrow Transplant. 2003;32(9):897-901.
Sloand, E., Childs, R. W., Solomon, S., Greene, A., Young, N. S., & Barrett, A. J. (2003). The graft-versus-leukemia effect of nonmyeloablative stem cell allografts may not be sufficient to cure chronic myelogenous leukemia. Bone Marrow Transplantation, 32(9), 897-901.
Sloand E, et al. The Graft-versus-leukemia Effect of Nonmyeloablative Stem Cell Allografts May Not Be Sufficient to Cure Chronic Myelogenous Leukemia. Bone Marrow Transplant. 2003;32(9):897-901. PubMed PMID: 14561990.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The graft-versus-leukemia effect of nonmyeloablative stem cell allografts may not be sufficient to cure chronic myelogenous leukemia. AU - Sloand,E, AU - Childs,R W, AU - Solomon,S, AU - Greene,A, AU - Young,N S, AU - Barrett,A J, PY - 2003/10/17/pubmed PY - 2004/7/9/medline PY - 2003/10/17/entrez SP - 897 EP - 901 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 32 IS - 9 N2 - We treated 12 patients with chronic myelogenous leukemia (CML) with a low-intensity preparative regimen followed by allogeneic stem cell transplantation in an attempt to confer a curative graft-versus-leukemia (GVL) effect with minimum morbidity. Seven patients in first chronic phase (CP1) and five in second chronic phase (CP2) (age 15-68 years) received a nonmyeloablative conditioning regimen of fludarabine and cyclophosphamide, followed by a G-CSF-mobilized peripheral blood stem cell (PBSC) transplant from an HLA-identical sibling. Cyclosporine (CsA) was used for graft-versus-host disease (GVHD) prophylaxis. Median follow-up was 384 days. Neutrophil recovery occurred at a median of 12 days. There was no transplant-related mortality. Of the seven CP1 patients transplanted, seven achieved a stable molecular remission; two with no post-transplant intervention, three after donor lymphocytes, imatinib and interferon, and two after a myeloablative stem cell transplant. Four of five CP2 patients died in blast crisis and one survived in molecular remission. Of the 12 patients with durable engraftment, six had Grades II-IV acute GVHD; six had limited chronic GVHD. These results suggest that cytoreduction is required to optimize the curative effect of allogeneic stem cell transplantation for CML. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/14561990/The_graft_versus_leukemia_effect_of_nonmyeloablative_stem_cell_allografts_may_not_be_sufficient_to_cure_chronic_myelogenous_leukemia_ L2 - https://doi.org/10.1038/sj.bmt.1704231 DB - PRIME DP - Unbound Medicine ER -